Brinkach I. Lumbar microdiscectomy peculiarities depending on topographic-anatomical variants of intervertebral discs hernias

Research object: discogenic compression radiculopathy. Research purpose: to improve the results of surgical treatment of patients with hernias of intervertebral discs of lumbosacral department of a backbone on the basis of the account of topographic-anatomical variants of hernias. Research methods: 1. Clinical and instrumental diagnostics of lumbar discs pathology by use of spondylography, MRI and CT, morphological researches, intraoperative studying of topographic-anatomical features of hernias localization and nerve roots, intraoperative video- and photofilmings and statistical data processing. 2. Differentiated microdiscectomy depending on topographic-anatomical variants of hernias localization. Results, novelty: topographic-anatomical variants of lumbar hernias depending on the level of their protrusion and topographic-anatomical features are determined; the features of a disk-radicular and a disk-dural conflicts depending on the level of lumbar hernias protrusion and their topographic-anatomical features are studied. The complex of preoperative diagnostic methods of topographic-anatomical variants of hernias is proved; the choice of the surgical approuches is optimized and microsurgical technics depending on topographic-anatomical features of hernias and pathological compression of nerve structures is advanced. It is established, that surgical access on the lumdar level should be determined on the basis of hernias localization and type, that allow to establish neurovisualization methods of researches (CT and МRI), and also topographic-anatomical ratio of disks, roots, bone structures and variants of lumbar hernias location. Efficiency of different ways of surgical interventions in occasion of lumbar hernias on the basis of criteria of operative treatment result predicting and an estimation of the remote results is determined. Sphere of application: The results of research are introduced in practical activities of backbone and spinal cord pathologies department of Institute of neurosurgery n.a.acad. A.P. Romodanov, spinal neurosurgery department of the Kiev city emergency hospital.